Primary sclerosing cholangitis (PSC) is a chronic progressive liver disease that is characterized by on-going inflammation and destruction of intrahepatic and extrahepatic bile ducts. Primary sclerosing cholangitis generally affects middle aged men and is the fourth leading indication for liver transplantation in adults in the United States. In this pilot trial, the efficacy of four different treatment regimens will be prospectively studied: 1)Ursodiol alone 2) ursodol and rotating oral antibiotics 3)ursodiol and low-dose oral methotrexate, and 4) Ursodiol with methotrexate and oral antibiotics.